NPIMap

Organization Active NPI

Abc123 Dental Centers PLLC

Doing business as ABC123 Dental

  • General Practice Dentistry
  • Crowley, TX
National Provider Identifier
1407105406
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
24637 Issued in TX
Legal business name
ABC123 DENTAL CENTERS PLLC
Doing business as
ABC123 Dental
Practice address
200 E Main St
Crowley, TX 76036-2680
Phone
(817) 656-1215
Fax
(877) 687-6861
NPI assigned
Sep 5, 2012
Last updated
Sep 5, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Peter Vo, DDS
Title
Dentist
Phone
(817) 656-1215

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 24637 TX Primary

Addresses

Primary practice location

200 E Main St
Crowley, TX 76036-2680

Mailing address

5416 Basswood Blvd
Fort Worth, TX 76137-4400
Phone (817) 656-1215

Other names 1

  • ABC123 Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Abc 123 Dental and Orthodontics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

200 E Main St
Crowley, TX 76036
Phone (817) 656-1215

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346803200000",
    "number": "1407105406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5416 BASSWOOD BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761374400",
            "telephone_number": "817-656-1215",
            "fax_number": "877-687-6861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E MAIN ST",
            "city": "CROWLEY",
            "state": "TX",
            "postal_code": "760362680",
            "telephone_number": "817-656-1215",
            "fax_number": "877-687-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABC123 DENTAL CENTERS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-05",
        "last_updated": "2012-09-05",
        "status": "A",
        "authorized_official_last_name": "VO",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "817-656-1215",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "24637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABC123 Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crowley, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.